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Acceptability of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with

Laura E Cowley1, Sabine Maguire1, Daniel M Farewell1

  • 1Division of Population Medicine, School of Medicine, Cardiff University, Wales, United Kingdom.

Child Abuse & Neglect
|May 13, 2018
PubMed

Insights

The Predicting Abusive Head Trauma (PredAHT) tool may boost child protection professionals' confidence in identifying abusive head trauma (AHT). However, consistent training is needed for uniform interpretation and court application.

Area of Science:

  • Pediatrics
  • Forensic Medicine
  • Social Work

Background:

  • Abusive Head Trauma (AHT) is a serious concern in child protection.
  • The Predicting Abusive Head Trauma (PredAHT) tool uses clinical features to estimate AHT probability.
  • Child protection professionals require validated tools to aid decision-making.

Purpose of the Study:

  • To assess the acceptability and utility of the PredAHT tool among diverse child protection professionals.
  • To explore professionals' preferred methods for presenting AHT probability data.
  • To understand how different professional groups interpret AHT risk.

Main Methods:

  • Qualitative semi-structured interviews with 56 UK-based child protection professionals.
  • Thematic analysis of transcribed interviews, with 38% double-coded for reliability.
  • Exploration of participants' evaluations, preferred probability presentation, and interpretation of AHT risk.

Main Results:

  • Clinicians, social workers, and police found PredAHT beneficial for objective decision support and confidence.
  • Legal practitioners and pathologists saw value in prompting multidisciplinary investigations but questioned court utility.
  • Concerns included potential over-reliance on low scores; precise percentages were preferred over general risk terms.

Conclusions:

  • PredAHT has potential to enhance professional confidence in investigating suspected AHT.
  • Multi-agency training is crucial for consistent interpretation and risk threshold definition.
  • The tool's value in legal settings may be limited without standardized interpretation and acceptance.

Keywords:
Abusive head traumaChild physical abuseChild protectionClinical prediction toolQualitative research

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